The present invention is directed to an apparatus and method for assisting a first person in maintaining a restraining hold on a second person for extended periods of time.
There are many thousands of human service and law enforcement agencies is and facilities that provide care and supervision to aggressive, suicidal, and emotionally disturbed persons (hereinafter commonly referred to as xe2x80x9cEDPsxe2x80x9d). The staff and officers working in these agencies regularly come into physical contact with the EDPs through the use of physical subduing or restraint holds when the EDP becomes aggressive. Although there are many types of well-known physical subduing holds, the safest and most advantageous physical subduing hold is a Primary Restraint Technique (PRT).
The PRT is an advantageous system of maneuvers that was developed by Bruce Chapman, a professional in the field of EDP care and supervision, from years of experience with subduing and restraining EDPs in a variety of environments. The PRT is a single person restraint that is applied from behind by engaging both arms of the EDP simultaneously or from the side by engaging one arm first followed by the other. The staff member engages or threads his arms through EDP""s arms so that the EDP""s elbows are underneath the staff member""s armpits, his chest held closely against the EDP""s back, hands overlapping or side by side with the palms flat or on edge against the EDP""s back, such that the staff member""s wrists and fingertips are pointed towards the EDP""s head. The act of turning the fingertips and wrists straight up in this configuration has the effect of making the PRT a mechanically correct xe2x80x9cskeletal lockxe2x80x9d and this distinguishes it from any other wrestling or subduing hold. The PRT can be further reinforced or stabilized by taking hold of clothing worn by the EDP but, even with closed fists (with or without clothing), the wrists must but be turned straight up in order to take full advantage of this passive xe2x80x9clockingxe2x80x9d effect. Essentially, the staff member""s upper and lower arm bones passively lock the upper and lower arm bones of the EDP without the use of muscularity or strength on the part of the staff member. The PRT cannot be broken with strength. It is this mechanical advantage that allows persons of modest size and strength to safely subdue stronger and larger EDPs than otherwise possible with any other passive subduing hold.
The PRT is implemented as a standing restraint, making it useful to control an EDP on their feet. Thus the PRT is particularly useful as a single person xe2x80x9crestrain and escortxe2x80x9d technique. However, there are also occasions when an EDP may continue to struggle after the PRT is applied, necessitating (for safety reasons) a xe2x80x9ctakedownxe2x80x9d by a staff member to the floor. A takedown method was devised to complement the PRT in order to eliminate virtually all of kinetic energy when the EDP is moved rearward into what is herein described as a xe2x80x9csettle positionxe2x80x9d. However, because the settle position is not particularly stable, a further technique was devised of turning the head of the EDP 180 degrees face down to a prone or what is described as a xe2x80x9cneutral positionxe2x80x9d. The neutral position eliminates virtually all of kinetic energy and impact forces that may be exerted by the staff member on the EDP as the EDP is turned face down.
The neutral position offers the maximum amount of control to the staff member due to the specific angle of the lower body of the staff member angled at an approximate 45 degree angle to the lower body of the EDP and with his hip slightly below and pressed tightly against the hip of an actively combatant EDPs. Although many EDPs regain composure relatively quickly, others can remain in a combative state for extended period of time. When the EDPs remain agitated for extended period of time (sometimes up to thirty minutes or longer) regardless of the restraint method used, the EDP may be exposed to what is described in the medical literature as positional asphyxiation resulting from accidental chest compression. Staff members of all sizes and weights work in various care agencies, subduing EDPs of all sizes and weights who are of varying degrees of physical health. Naturally, the problem of chest compression is exacerbated as the difference in size between the staff member and the EDP becomes greater in favor of the staff member, as is often the case when adults restrain children and juveniles, and the longer the restraint is maintained. The combination of chest compression and fatigue on the part of the EDP""s of all ages and sizes can be fatal and it is an increasing concern in the human service industry.
The PRT in the neutral position is the only prone-type restraint technique that enables staff members to eliminate virtually all of their weight from an EDP""s chest, thereby rendering positional asphyxiation virtually impossible. Maintenance of the neutral position is made possible using the xe2x80x9ctripod modificationxe2x80x9d technique. The tripod modification is a method whereby the staff member shifts their entire upper body weight to an xe2x80x9coutside elbowxe2x80x9d and to a lessor extent one or both knees. It is the ability to eliminate the entire body weight from the EDP that distinguishes the PRT in the neutral position from any other prone restraint or subduing hold method. Despite this feature, the size of the EDP, the surface of the floor covering in the location of the engagement of the PRT neutral position, the duration of the prone restraint and other factors can make it difficult to maintain a tripod modification.
Thus, it would be desirable to provide an apparatus or method to assist a staff member in maintaining the PRT in the tripod modification for an extended period of time, thereby reducing the danger of positional asphyxiation of the EDP.
The apparatus and method of use thereof of the present invention remedies the problems associated with extended restraining holds and encourages and reminds staff members to maintain a tripod modification throughout the entire restraint procedure. In brief summary, the apparatus protects, cradles, stabilizes and elevates the staff member""s outside elbow, enabling the staff member to maintain tripod modification comfortably, for an extended period of time with EDP""s of various sizes and with greatly reduced risk and discomfort to the EDP.
The Primary Restraint Technique (hereinafter xe2x80x9cPRTxe2x80x9d) is an advantageous modular single person restraint that is applied by an EDP care professional (hereinafter xe2x80x9cstaff memberxe2x80x9d) to an EDP from behind by engaging both arms simultaneously or from the side by engaging one arm followed by the other. The maneuvers involved in implementing the PRT are illustrated in FIGS. 1A to 1G. One of the advantages of the PRT is that it utilizes a xe2x80x9cmodularxe2x80x9d approach. The PRT includes separate techniques, or xe2x80x9cmodulesxe2x80x9d may be implemented by the staff member to accomplish different objectives with respect to the EDP. The modules include an initial xe2x80x9cstanding restraintxe2x80x9d a xe2x80x9ctakedownxe2x80x9d, a xe2x80x9cneutral positionxe2x80x9d, and a xe2x80x9ctripod modificationxe2x80x9d.
In the initial xe2x80x9cstanding restraintxe2x80x9d module of the PRT a staff member approaches an EDP from behind. The staff member engages or threads his arms through EDP""s arms so that the elbows are underneath the staff member""s armpits, the staff member""s chest held closely against the EDP back, hands overlapping with the palms flat against the EDP back, such that the staff member""s wrists and fingertips are pointed towards the EDP head. The act, by the staff member, of turning the fingertips and wrists straight up in this configuration has the effect of making the PRT a mechanically correct xe2x80x9cskeletal lockxe2x80x9d and this distinguishes it from any other wrestling or subduing hold. The PRT cannot be broken with strength. It is this mechanical advantage that allows persons of modest size and strength to safely subdue stronger and larger EDP than otherwise possible with any other passive subduing hold.
The initial standing restraint module of the PRT is useful to control an EDP on their feet. Thus, the PRT is particularly useful as a single person xe2x80x9crestrain and escortxe2x80x9d technique. However, there are also occasions when an EDP may continue to struggle after the PRT is applied, necessitating (for safety reasons) a takedown of the EDP by the staff member to the floor into the xe2x80x9cneutral positionxe2x80x9d where the struggling EDP may be better restrained. A xe2x80x9ctakedownxe2x80x9d module was devised to complement the PRT in order to eliminate virtually all of kinetic energy when the EDP is moved to the neutral position.
The standard takedown module is initiated after the standing restraint when the staff member takes a deep step back, lowering his or her center of gravity and drawing the EDP off-balance. During this maneuver, the staff member maintains his or her palms against the EDP back to support the EDP weight. The staff member then lowers his or her (deep stepping) knee to the floor followed by the other knee, slowly staging the EDP descent to a sitting position. The staff member""s move to a kneeling position while maintaining the EDP in the sitting position is known as the xe2x80x9csettle positionxe2x80x9d. There are also two alternative takedown modules (the xe2x80x9cAxe2x80x9d Frame and xe2x80x9cHigh Speed xe2x80x9cAxe2x80x9d Frame takedownsxe2x80x94not depicted) that involve simultaneously stepping or hopping with both legs and simultaneously lowering both knees to the settle position. However, because the settle position is not particularly stable, a further technique was devised for enabling the staff member to shift the EDP face down to the more stable, prone, xe2x80x9cneutral positionxe2x80x9d. To place the EDP in the neutral position from the settle position, the staff member 10 pivots his or her knee to gently initiate the move and straightens the other leg to complete a turn of the EDP 180 degrees into the xe2x80x9cneutral positionxe2x80x9d. This manner of turning to the neutral position eliminates virtually all of kinetic energy and impact forces that may be exerted by the staff member on the EDP as the EDP is turned face down.
The neutral position offers the maximum amount of control, to the staff member, of actively combatant EDP. Although many EDPs regain composure relatively quickly, others can remain in a combative state for extended period of time. When the EDP remains agitated for an extended period of time regardless of the restraint method used, the EDP may be exposed to what is described in the medical literature as positional asphyxiation. Staff members of all sizes and weights work in various care agencies, subduing EDPs of all sizes and weights who are of varying degrees of physical health. Naturally, the problem of chest compression is exacerbated as the difference in size between the staff member and the EDP becomes greater in favor of the staff member, and the longer the restraint is maintained. The combination of chest compression and fatigue on the part of the EDP 12 can be fatal and it is an increasing concern in the human service industry.
The PRT in the neutral position is the only prone-type restraint technique that enables a staff member to eliminate virtually all of their weight from the EDP""s chest, thereby rendering positional asphyxiation virtually impossible. Maintenance of the neutral position is made possible using a xe2x80x9ctripod modificationxe2x80x9d PRT module. To achieve tripod modification, the staff member shifts their entire upper body weight to the outside elbow while maintaining some support with both knees as necessary. It is the ability to eliminate the entire body weight of the staff member from the EDP that distinguishes the PRT in the neutral position from any other prone restraint or subduing hold method. Despite the advantages of the tripod modification, the size of the EDP, the surface of the floor covering in the location of the engagement of the PRT neutral position, the physical size and condition of the staff member, the duration of the prone restraint and other factors can make maintenance of the tripod modification by the staff member a difficult task.
The apparatus of the present inventionxe2x80x94a tripod support standxe2x80x94operatively assists the staff member in comfortably maintaining the tripod modification module over the EDP for an extended period of time, while eliminating the danger of positional asphyxiation. Furthermore, the inventive apparatus enables a smaller staff member to apply and maintain the tripod modification over a larger EDP.
In a first embodiment of the present invention, a tripod support stand includes a first resilient pad of a predetermined thickness having a top surface with a receiving channel for receiving the staff member""s elbow disposed thereon, and a substantially flat bottom surface having a centrally positioned extruded area, generally corresponding to the position of the receiving channel, and an optional second resilient pad having, on its upper surface, a receiving indentation generally shaped and postioned to align with, and receive the extruded area of the first resilient pad. When the first and second resilient pads come into contact and pressure is applied into the receiving channel by the staff member""s elbow, the extruded area enters the receiving indentation and creates a vacuum seal releasably attaching the first resilient pad to the second resilient pad. After utilization, the first and second resilient pads may then be detached from one another with relative ease by pulling them apart to break the vacuum seal between the extruded area and the receiving indentation.
A bottom area of the second resilient pad may optionally be configured to provide limited movement on contact with a floor surface to facilitate potentially necessary movement of the staff member during utilization of the tripod stand. The tripod support stand also advantageously extends the reach of the staff member""s elbow so that contact with the floor surface may be accomplished via the first resilient pad (alone or in combination with the second resilient pad), and so that the staff member may be comfortably elevated over the EDP.
In another embodiment of the invention, the second resilient pad is identical to the first resilient pad and the tripod stand is utilized in a similar manner to the previous embodiment except that the receiving channel of the second resilient pad is aligned with the extruded area of the first resilient pad to form the vacuum seal as the staff member""s elbow contacts and applies pressure to the receiving channel of the first resilient pad.
The method of utilization of the tripod support stand is very simple. When the staff member places the EDP into the tripod modification position, a second staff member (not shown) places the tripod support stand consisting of the first resilient pad under the elbow of the staff member such that the elbow enters the receiving channel. If necessary, the second staff member adds the second resilient pad under the first one to elevate the position of the tripod support stand, and thus the elbow, above the floor surface.
Other objects and features of the present invention will become apparent from the following detailed description considered in conjunction with the accompanying drawings. It is to be understood, however, that the drawings are designed solely for purposes of illustration and not as a definition of the limits of the invention, for which reference should be made to the appended claims.